PRISONS ARE NOT ASYLUMS

There once was a time when visitors could pay a small fee to enter
London's notorious Bethlehem Royal Hospital, or Bedlam as it was
known, and view the residents for an afternoon's entertainment.

Today, we like to think our treatment of the mentally ill is a world
away from the era of putting asylum patients on display. But it is not
as modern and humane as many like to think.

The mentally ill make up a growing proportion of Canada's prison
population and many are receiving inadequate treatment, or none at
all. It is no wonder former Senator Michael Kirby -- who chaired an
exhaustive study of mental health in Canada -- calls prisons the
asylums of the 21st century.

Canadian prisons are poorly equipped to handle the growing ranks of
offenders who have a mental illness. As Canada's prison ombudsman,
Howard Sapers, warns in his just-released annual report, the number of
mentally ill inmates is on the rise, while health services to treat
them are deteriorating.

Mentally ill prisoners are simply being warehoused. Prison staff often
resort to isolating these inmates, in order to get them under control.
Isolation is not treatment. "This is an inhumane and unsafe way to
address offenders with mental illness," said Penny Marrett, head of
the Canadian Mental Health Association, in response to the report.

The number of inmates with mental illness has soared. In 1998,
according to Corrections Canada, 1,000 inmates out of a prison
population of 14,000 were diagnosed with mental-health disorders. By
2004, that number had risen to 1,500, out of a prison population of
12,500.

Sapers' warnings about the growing mental health challenge in prisons
is timely, considering that prison populations are likely to swell,
owing to judicial reforms such as minimum mandatory sentences. The
problems associated with prison overcrowding only intensify when
people suffering from serious illnesses, up to and including
psychosis, are thrown into the mix.

The situation is dangerous. It's dangerous on the inside, where
violence leads to lockdowns and overdependency on solitary
confinement. It's also dangerous for those of us on the outside,
because a mentally ill offender who has not received treatment may be
in worse shape when he gets out than when he went in.

Corrections Canada is trying to address these issues, but Ombudsman
Sapers says that what ultimately is needed is funding to provide the
health services inmates require. The prison system currently has only
about half the acute psychiatric beds that are needed.

It's sad that it took a dramatic case like that of Ashley Smith to
expose this gap in the corrections system. Ashley was the teenager who
choked herself to death in a prison cell while guards stood outside.
Apparently Smith was made to endure a "highly restricted and at times
inhumane segregation," as Sapers put it. "There is reason to believe
that Ms. Smith would be alive today if she had not remained on
segregation status and if she had received appropriate care."

We don't deny antibiotics to a prisoner who has bacterial pneumonia,
and we shouldn't deny psychiatric care to a prisoner who is suicidal
or delusional.

No one should mistake this as being "soft on crime." By all means,
let's keep offenders locked up, for long periods of necessary. The
point is simply that we mustn't gratuitously torment them while they
are in there, which is what happens when necessary medical treatments
are withheld.